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My 90-year-old mother was diagnosed with Alzheimer's 2 years ago. I am the only child, so when I leave town I would arrange for respite stay for her at a nice nursing home. She is an intelligent, physical fit person. I have managed to keep her in her own home by spending a lot of time with her and hiring a retired nurse who comes in 3 hours once a week. But it has been exhausting and often times there have been arguments between us. For the last year she had been gradually going down hill.


This recent respite stay the nursing home reported that she began to wander. They placed her on 30 minute watch, and then an ankle monitor which she has removed twice. The NH said she needed to go to a memory unit because they can't manage her wandering safely. The unit which they are associated with doesn't have availability, so the solution was for me to hire 1 to 1 care 12 hours a day from an outside agency. I have done as they have asked.
This has occurred in the last week and I keep having such range of feelings about this. If feel relief because I am not doing this alone, but I have huge guilt because I am second guessing if this is the right decision. I scheduled a separate appointment with her GP, but he wouldn't advise as what to do. His view is that her problem is something which he can't medicate, so it's not his problem. My mom doesn't know that I am back in town because she will want to go home. I have called her and she asks me when I am going to be home. I was willing to have her stay at the NH because she has made friends and has a better social life than I alone can provide. But I am concerned that having her in a memory unit will sacrifice her safety over the socialization and comradity she has made at the NH. I am very conflicted about doing the right thing for me mom. Any insight would be very appreciated.

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Tough issues, here.

In my experience, the folks in the one memory care unit my mother was in briefly were, overall, higher functioning than the folks who are currently on her non-dementia unit at a nearby NH.

Have you toured the memory care unit? Have you been to others nearby? If your mom still has the brain cells to socialize, she will find opportunities to socialize wherever she is, I think.

I would resort to therapeutic fibbing (the doctor says you need to stay here until you get stronger; I need some time to recover from my own recent illness; something like that) to get her over the hump of what will most likely become a permanent placement.
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It is a big consideration. I'm not sure what level of interaction with other residents that she's having at the NH, but, you could check the Memory Care units and see what their situation currently is.  This changes from day to day though.

 I know that when I toured facilities, I visited a Secure Memory Care facility that was very upscale. It actually resembled a spa resort. While touring I saw a group of ladies in the social room, playing cards. All were dressed nicely, wearing jewelry, nice hairstyles. and they were chatting as you would expect to see at any regular senior center. I suspected that they were there due to wandering and perhaps had pretty good skills otherwise. Most of the Nursing homes that I visit, have very sick residents who are bed bound, so, it's really something I'd just explore.  Of course, the condition of the residents will progress.

You are making decisions for her best interest and whatever you chose will be the right decision, imo. I'd feel guilt if I left her free to wander, but, protecting her is the right course. I'd try to move forward with that belief.

I will say that, when I moved my LO from a regular AL to a Secure Memory Care, she seemed to finally relax. I sensed that she felt safe and at home there. I think she sensed that she was with other people who had dementia and that the staff was able to care for her properly. She needed more can than a regular AL.

I might discuss the progression of the dementia with her doctor, so you will know what to expect as she progresses. That would be a factor to consider as well as the costs associated with having a one on one sitter. I would imagine that would be rather expensive.
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PS

I remember someone saying that placing their 90 something mom in memory care was the wrong decision simply because she could still talk and the other residents couldn't

Please tour facilities and ask to go in the evening hours after dinner as well

They are not at all what they are like on a Saturday afternoon
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I have toured memory care units vs nursing homes & do prefer a memory care specific for ALZ, dementia & memory impairments. Some of the memory care facilities have different areas depending on the stage a loved one is in. Later stage individuals requiring more one on one attention may have a private area & when needed may be moved to a nursing facility or a hospital for medical care. In a memory care facility I've found staff to be more experienced & knowledgeable in memory impairment. The whole purpose is to keep most everyone engaged & socializing. A schedule with routine, consistency & structure seem to be what a good facility strives for. Mind you there are all kinds of facilities & the ones we love are not cheap, you get what you pay for is true. Lower cost ones, don't waste your time even touring, run don't walk from these. If there is wandering a lock down is peace of mind for you & the monitoring tags are an extra protection as well. An assessment is usually done to determine what level of care is needed, be forthright & honest, experienced personnel should know the right care needed. Some facilities offer trial periods to make sure it's the right fit. Make inquiries, visit more than once, speak to others. You should get "that good feeling." Trust yourself. Good luck & God Bless!🌸
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Goodkid

Your mom sounds a little like mine. My mom is 93 with Alzheimer's. She lived with me for 2 years (she thought she was just visiting). During that time she went to an adult day center that specialized in dementia and she loved it. They kept her engaged and entertained. She moved in to a locked memory care unit this past August. That was extremely difficult because she was happy at the day center, the socialization was good for her and she believed she was going to work every day. The move to memory care was a big adjustment. I moved her because an opening came up at the facility I liked and I took it.

Things to consider - tour several facilities - they are all different. Each Sunrise I toured was different. Some places looked like a nursing home and some looked trendy. Know what her finances are. Is your mom considered high functioning? If the NH recommends a locked memory care unit - than that is probably what she needs. Dementia is a progress disease and she will get worse. You don't want to place her in an AL or NH facility and then have to move her again because they can't handle her when the disease progresses. She really needs to be in a dementia specialized facility.

Think about what your mom likes. I wanted a place that had activities, that looked more modern, had outside gardens, a place to get her hair done, and that provided end of life care. When I first placed her, I was sad because many of the people were worse off than her and she didn't have the socialization she did at day care. That has changed over time and higher functioning memory care residents can participate in functions on the assisted living side. I really am happy with the facility where she lives.

There is no perfect scenario here. You can only do the best you can and work with the finances you have. Wandering was starting to become a problem for my mom too. When she gets upset, she wants to to live with her parents. There is help out there, A Place for Mom was very helpful to me. Good luck.
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When I was made POA for two childless friends of mine, I started researching AL facilities in our area. Only one had memory care apartments large enough for two people--a choice of two bedroom, one bedroom or efficiency. When the wife began to wander and was incontinent, I was told she needed 24 hour care and convinced them to go to a one bedroom apartment in that facility. While another friend took them for breakfast and to have their nails done, Caring Transitions and I moved their bedroom and den furniture to the new apartment, making it look just like home. They immediately adapted to it and began to make friends with the other residents. The care was quite good and we were told they would never have to leave. The wife only lasted another 5 months before her brain was just shutting down and she could no longer swallow. The care and advice I was given to meet their needs was excellent and they kept meticulous records of their observations and staff interactions with them. The husband is still happy to be there. He likes the socializing at meal times but doesn't enjoy games. He will listen when there is a musical offering, but otherwise watches TV and reads the paper. I feel so fortunate to have found a place that worked so perfectly for them. They also agreed to accept public financing should we run out of money once 18 months of regular payments were made, so my friend will never need to leave. Hospice came in for the wife's needs near the end of her life and did an excellent job of monitoring her and keeping her comfortable.
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My best friend's husband needed to go to a lockdown facility. She lives in Palm Springs, CA. There were three in her area. Two were like jails where you never were allowed outside. The third one in Rancho Mirage was wonderful. They had three buildings for different levels of dementia. They had double fencing and the inside fence enclosed the buildings, and a lovely garden with sidewalks. The doors were unlocked during the day and people could go out and wonder around without ever leaving the compound. They had kitchens with no sinks or stoves, just cupboards that the ladies would clean and rearrange the plastic dishes. A wonderful place, and cheaper than the ones in Palm Springs. Go figure. So, like everyone else said, go look at what they have. Not just for now but for the future. My friend fought with them every time Bob had to go to a more care building, but they would assure her it was time for him to go.
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My dad has Vascular Dementia. Two years ago, a few months after my mom died (mainly due to caring for my dad 24x7 and not caring for herself), we placed my dad in a community specializing in memory care. My wife and I looked at many options. Given the fact that dementia requires additional care and security we felt as though we wanted my dad to be protected, cared for and that he could age-in-place. One of my concerns was that I only wanted to move my dad once since had been living in the same house for 52 years. Now that my dad has been at his community for close to 2 years and his condition has deteriorated I recognize that this was the best choice for him and my family.
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I take my alz spouse to what is only memery care. They have doors patients can go out on large lawn area w secured high fence they can see out. They have pods according to abilities where they also eat. The activities are in largest rm. Adult day care is available too which hubby attends. He enjoys his Social time there w people like him so no pressure. Sometimes there are persons that know all places & can help you find best place for your situation.
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We recently put mom in a memory care unit and it was the best decision since she began to struggle with alzheimers. A memory care unit is more secure for the residents so there is less risk of them getting way and lost. She has blossomed in her memory care as they provide activities throughout the day, crafts, singing etc. She has actually regained memory skills, and is very happy as opposed to being previously frustrated and depressed. Visit memory care units in your area. Pick a place where you can visit anytime.
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